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Neurology (Expert Forum)
Neurologist Exams Clean, Some Symptoms Persist
Answered by
Cleveland Clinic, MD - Neurology
Cleveland Clinic
Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Neurologist Exams Clean, Some Symptoms Persist
by lucyp0 , Aug 24, 2007 12:00AM
I'm female, 39 yrs old, in overall good health. 3 months ago, I had severe burning on the bottoms of my feet followed by a pins and needles sensation on the tops of the feet that spread to the legs from the knee down. This sensation then spread to my arms and hands, with a bruised feeling in my fingers and a stiffness on the backs of my hands and the tops of my feet. I also had a low grade fever with general fatigue for about two weeks. My chin began to ache soon after this, as well, with a feeling of sunburn on my legs without visible redness or irritation. A series of blood work showed normal CBC, thyroid, iron, B12 and rheumatoid factor. Reflexes were normal. GP referred me to a neurologist who found nothing abnormal after a thorough exam, MRI of brain and neck w/ & w/out contrast, EMG of leg and arm, nerve conduction velocity of leg and arm and evoked response of hands. Neurologist said I should follow up in 6 months if symptoms persist for another MRI, saying I'm not a possible MS at this time but we want to watch for it; said I should have been better by now if just a virus. The pins and needles and burning sensation have mostly subsided, but I now have muscle aches in the legs and hands with some twitching from time to time. The muscle on the top of my foot tires easily after driving, and my arms feel fatigued after reaching up for just a minute or two. Should I seek an opinion from a rheumotologist? Any idea as to what my problem could be?
Doctor's Answer
by Cleveland Clinic, MD, Nov 15, 2007 09:45AM
, Nov 15, 2007 09:45AM
To: lucyp0
I am happy to address the questions that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a substitute for an office visit with a neurologist. Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.
Your symptoms remain non-specific and it is really hard to pin point a specific disease process that can cause such symptoms, especially with the normal physical exam and the unremarkable workup you had done so far.
if you still have the symptoms persistant I believe it is a good idea to re-evaluate you by obtaining a detailed medical history and perform a thorough physical and neurological examination. Then may be repeating some testing to make sure nothing was missed with the first round of testing. primary concerns are muscle and nerve diseases. if everything turns out to be negative again then an evaluation by a rheumatologist is reasonable. another thought to consider is the stress factor, sometimes exessive stress (that can be sometimes difficult to pick up by the patient himself) can cause a variety of physical symptoms, including the ones you mentioned. I beileve addressing this issue can be helpful as well.
Good luck, I hope you find some answers soon.
Your symptoms remain non-specific and it is really hard to pin point a specific disease process that can cause such symptoms, especially with the normal physical exam and the unremarkable workup you had done so far.
if you still have the symptoms persistant I believe it is a good idea to re-evaluate you by obtaining a detailed medical history and perform a thorough physical and neurological examination. Then may be repeating some testing to make sure nothing was missed with the first round of testing. primary concerns are muscle and nerve diseases. if everything turns out to be negative again then an evaluation by a rheumatologist is reasonable. another thought to consider is the stress factor, sometimes exessive stress (that can be sometimes difficult to pick up by the patient himself) can cause a variety of physical symptoms, including the ones you mentioned. I beileve addressing this issue can be helpful as well.
Good luck, I hope you find some answers soon.
Karen
If you want some temporary relief with medication, get "nortriptolene". It deals with nerve damage pain and it works well.